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Use of computed tomography colonography to detect a synchronous early colorectal cancer in a patient with obstructive colorectal tumour
Author(s) -
Watanabe Toshiaki,
Matsuda Keiji,
Ishihara Soichiro,
Nozawa Keijiro,
Hayama Tamuro,
Yamada Hideki,
Iinuma Hisae
Publication year - 2012
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2011.00580.x
Subject(s) - medicine , colonoscopy , colorectal cancer , radiology , lesion , transverse colon , pathological , adenocarcinoma , cancer , surgery
In patients with obstructive colorectal cancer, it is difficult to evaluate the oral site of the large bowel by colonoscopy. Instead of colonoscopy, previous studies have shown that computed tomography (CT) colonography is effective for detection of neoplastic lesions in the large bowel. In the present case, we carried out CT colonography and found superficial early cancer at the oral side of the obstructive cancer, and carried out surgical resection for both lesions. A 60‐year‐old man was admitted with complaints of abdominal pain and distension. Total colonoscopy could not be carried out because of the stricture of the lesion. To evaluate the proximal site of the large bowel, we carried out CT colonography, which showed a superficial lesion in the transverse colon suggestive of early cancer. He underwent surgery and an intraoperative colonoscopy of the transverse colon, which confirmed the findings of the CT colonography. The patient underwent R0 resection for both an advanced lesion and a superficial lesion. Pathological examination of the superficial lesion showed adenocarcinoma‐invading submucosa. The postoperative course was uneventful and the patient was discharged a week after the operation. The present case suggests the importance of CT colonography for patients with obstructive colorectal cancers to detect synchronous neoplastic lesions, including superficial early cancers.